Teleneurosurgery can play a vital role in the care of patients in hospitals and community health settings where neurosurgical expertise is not available. The combination of audiovisual interaction of a neurosurgeon with the emergency physician, the patient and the patient’s family, combined with an intense education program delivered to the originating site care team, has greatly enhanced the appropriate triage of patients in community hospitals. The result is better patient care, improved patient and family satisfaction, cost savings, and the retention of patients within the local community care system, as well as the improved sustainability of the wider health delivery system. To succeed, start-up financial support is often needed to provide the required technical elements and 24/7 neurosurgical availability.